U.S. patent application number 11/881059 was filed with the patent office on 2008-01-31 for clip apparatus for ligaturing living tissue.
This patent application is currently assigned to OLYMPUS MEDICAL SYSTEMS CORP.. Invention is credited to Koh Kimura, Motoi Satake.
Application Number | 20080027467 11/881059 |
Document ID | / |
Family ID | 38606641 |
Filed Date | 2008-01-31 |
United States Patent
Application |
20080027467 |
Kind Code |
A1 |
Satake; Motoi ; et
al. |
January 31, 2008 |
Clip apparatus for ligaturing living tissue
Abstract
A clip apparatus for ligaturing a living tissue includes a clip
unit provided removably at a distal end of an insertion part
inserted into a forceps channel of an endoscope, and an operating
part for the unit, extending in an passage of the insertion part.
The unit has a clip holder in an opening of the passage and a
passage for elastically opening/closing of a clip, an engaging
portion to be opened elastically around the passage when the holder
projects from the passage, and longitudinally engaged with the
distal end of the insertion part, and a structure preventing
excessive opening of the engaging portion when a member connected
to the clip and the operating part and moving in the passage is
broken at a breakable portion by a pulling force from the operating
part.
Inventors: |
Satake; Motoi; (Chofu-shi,
JP) ; Kimura; Koh; (Hachioji-shi, JP) |
Correspondence
Address: |
SCULLY SCOTT MURPHY & PRESSER, PC
400 GARDEN CITY PLAZA, SUITE 300
GARDEN CITY
NY
11530
US
|
Assignee: |
OLYMPUS MEDICAL SYSTEMS
CORP.
Tokyo
JP
|
Family ID: |
38606641 |
Appl. No.: |
11/881059 |
Filed: |
July 25, 2007 |
Current U.S.
Class: |
606/143 |
Current CPC
Class: |
A61B 17/083 20130101;
A61B 17/1227 20130101; A61B 17/1285 20130101; A61B 2090/037
20160201 |
Class at
Publication: |
606/143 |
International
Class: |
A61B 17/10 20060101
A61B017/10 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 25, 2006 |
JP |
2006-202342 |
Claims
1. A clip apparatus for ligaturing a living tissue comprising: an
insertion part which includes a distal end portion, a proximal end
portion and a passage extending between the distal end portion and
the proximal end portion and which is inserted into a forceps
channel of an endoscope inserted into an body cavity of a living
thing with the distal end portion being as an leading end; a clip
unit which is removably provided in the distal end portion of the
insertion part and which includes a clip having slender arms having
independent distal ends and proximal ends connected to each other,
the clip being capable of elastically opening and closing the
distal ends; and a clip operating part which includes an external
operation portion exposed at the proximal end portion of the
insertion part and a clip connecting portion extending in the
passage of the insertion part from the external operation portion
to the distal end portion and connected to the clip unit and which
is configured to open and close the clip of the clip unit by
operating the external operation portion, wherein the clip unit
includes a clip holding member which has a diameter smaller than
that of the opening of the passage in the distal end portion of the
insertion part and a clip projecting/retracting passage extending
along a longitudinal center line of the passage, holding the clip
to be capable of projecting and retracting the clip, and
elastically opening and closing the arms of the clip by projecting
and retracting of the clip; an engaging portion which is provided
around the clip projecting/retracting passage in the clip holding
member and which is elastically openable and closable in a radial
direction of the clip projecting/retracting passage, the engaging
portion being pushed by an inner circumferential surface of the
passage and elastically closed while the clip holding member is
retracted in the opening of the passage in the distal end portion
of the insertion part, and elastically opened when the clip holding
member projects from the opening of the passage and engaging with a
periphery of the opening of the passage in the distal end portion
of the insertion part in a direction along the longitudinal center
line of the passage; a connecting member which is provided in the
clip projecting/retracting passage of the clip holding member to be
movable in an extending direction of the clip projecting/retracting
passage, which is connected to the proximal ends of the arms and
the clip connecting portion of the clip operating part to move
together with the clip in the clip projecting/retracting passage in
the extending direction by operating the clip operating part, and
which has a breakable portion and a distal end portion closer to
the clip than the breakable portion, the breakable portion being to
be broken when a pulling force higher than a predetermined value is
applied by the clip operating part; and an engaging portion
excessive opening preventing structure which prevents excessive
opening of the engaging portion by a deviating force directed
outward in the radial direction and applied to the distal end
portion of the connecting member as the breakable portion of the
connecting member is broken.
2. The clip apparatus according to claim 1, wherein the engaging
portion excessive opening preventing structure includes an opening
restriction portion which is provided in the engaging portion,
which has a facing region facing a part adjacent to the opening of
the passage of the insertion part in an inner circumferential
surface of the passage while the engaging portion is elastically
opened, and which restricts the opening of the engaging
portion.
3. The clip apparatus according to claim 2, wherein the facing
region of the opening restriction portion is configured by a slope
inclined inward in a radial direction of the passage of the
insertion part as separating from the opening of the passage of the
insertion part along an extending direction of the passage of the
insertion part.
4. The clip apparatus according to claim 2, wherein the breakable
portion of the connecting member includes a cut out which is cut
from a part of an outer circumferential surface of the connecting
member inward in a radial direction of the clip holding member and
which extends in a direction crossing the extending direction of
the clip projecting/retracting passage; and the proximal ends
connected to each other in the slender arms of the clip are hooked
in the cut out.
5. The clip apparatus according to claim 1, wherein the engaging
portion excessive opening preventing structure includes a setting
of a distance from a clip projecting/retracting opening of the clip
projecting/retracting passage of the clip holding member to a
distal end of the engaging portion, the distal end being located in
a side of the clip projecting/retracting opening, longer than a
distance from the distal ends of the arms of the clip to a distal
end of the distal end portion located closer to the distal ends of
the clip than the breakable portion in the connecting member.
6. The clip apparatus according to claim 5, wherein the breakable
portion of the connecting member includes a cut out which is cut
from a part of an outer circumferential surface of the connecting
member inward in a radial direction of the clip holding member and
which extends in a direction crossing the extending direction of
the clip projecting/retracting passage; and the proximal ends
connected to each other in the slender arms of the clip are hooked
in the cut out.
7. The clip apparatus according to claim 1, wherein the engaging
portion excessive opening preventing structure includes separating
and making independent an opening/closing direction of the engaging
portion and a direction in which the deviating force directs from
and of each other in a circumferential position around the
extending direction of the clip projecting/retracting passage.
8. The clip apparatus according to claim 7, wherein the breakable
portion of the connecting member includes a cut out which is cut
from a part of an outer circumferential surface of the connecting
member inward in a radial direction of the clip holding member and
which extends in a direction crossing the extending direction of
the clip projecting/retracting passage; and the proximal ends
connected to each other in the slender arms of the clip are hooked
in the cut out.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is based upon and claims the benefit of
priority from prior Japanese Patent Application No. 2006-202342,
filed Jul. 25, 2006, the entire contents of which are incorporated
herein by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] This invention relates to a clip apparatus for ligaturing a
living tissue.
[0004] 2. Description of the Related Art
[0005] Each of Jpn. Pat. Appln. KOKAI Publication Nos. 2002-191609
and 2004-121485 discloses a clip apparatus for ligaturing a living
tissue comprising: an insertion part which is to be inserted into a
forceps channel of an endoscope inserted into a body cavity of a
living thing; a clip unit which includes a clip provided removably
at a distal end portion of the insertion part and configured to be
open and close; and a clip operating part which includes an
external operation portion exposed at a proximal end portion of the
insertion part and a clip connecting portion extending from the
external operation portion to the distal end portion in the
insertion part and connected to the clip unit, and which is
configured to open and close the clip of the clip unit by operating
the external operating portion.
[0006] Such conventional clip apparatus for ligaturing a living
tissue will be explained hereinafter with reference to FIG. 5 to
FIG. 8B.
[0007] As shown in FIG. 5, an insertion part 10 of a conventional
clip apparatus for ligaturing a living tissue includes a distal end
portion 10a, a proximal end portion 10b, and a passage 10c
extending between the distal end portion 10a and the proximal end
portion 10b. The insertion part 10 is inserted into a forceps
channel of a not-shown endoscope inserted into a body cavity of a
living body, for example a living body, with the distal end portion
10a being as a leading end.
[0008] In the above conventional clip apparatus, a clip 12 included
in a clip unit 14 provided removably at the distal end portion 10a
of the insertion part 10 has slender arms 12c having independent
distal ends 12a and other ends 12b connected to each other, and is
capable of elastically opening and closing the distal ends 12a.
[0009] In the above conventional clip apparatus, a clip operating
part 16 being capable of opening and closing the clip 12 of the
clip unit 14 includes an external operation portion 16a exposed at
the proximal end portion 10b of the insertion part 10 and a clip
connecting portion 16b extending in the passage 10c of the
insertion part 10 from the external operation portion 16a to the
distal end portion 10a of the insertion part 10 and connected to
the clip unit 14. And, the clip 12 of the clip unit 14 can be
opened and closed by operating the external operation portion
16a.
[0010] In the not-shown endoscope, If the insertion part in which
the forceps channel is extending does not have flexibility, each of
the insertion part 10 and clip operating part 16 of the clip
apparatus may not have flexibility. However, if the insertion part
of the not-shown endoscope has flexibility, each of the insertion
part 10 and clip operating part 16 of the clip apparatus must have
flexibility in order to follow curving of the insertion part of the
endoscope.
[0011] Next, a configuration of the conventional clip unit 14 will
be explained with reference to FIGS. 5, 6A and 6B.
[0012] The clip unit 14 comprises a clip holding member 18 whose
diameter is smaller than that of an opening of the passage 10c in
the distal end portion 10a of the insertion part 10. The clip
holding member 18 has a clip projecting/retracting passage 18a
which extends along a longitudinal center line of the passage 10c
and which holds the clip 12 in a projectable/retractable state.
When the clip 12 is projected from and retracted into the clip
projecting/retracing passage 18a, outside surfaces of the arms 12c
of the clip 12 slidingly contact an inner circumferential surface
of the clip projecting/retracting passage 18a so that the arms 12c
are elastically opened and closed.
[0013] The clip unit 14 further comprises engaging portions 20
which are provided around the clip projecting/retracting passage
18a in the clip holding member 18 and which are radially and
elastically openable and closable relative to the clip
projecting/retracting passage 18a. Each of the engaging portions 20
is slender in a longitudinal direction of the clip
projecting/retracting passage 18a. And, only a distal end of the
engaging portion 20 in a direction in which the clip holding member
18 projects from the opening of the passage 10c in the distal end
portion 10a of the insertion part 10 is connected to a
circumferential wall of the clip holding member 18 while the
engaging portion 20 excluding the distal end is separated from the
circumferential wall of the clip holding member 18. While the clip
holding member 18 is retracted in the opening of the passage 10c in
the distal end portion 10a of the insertion part 10, each of the
engaging portions 20 is pushed by the inner circumferential surface
of the passage 10c and elastically bent (that is, closed) about the
distal end radially inward relative to the clip
projecting/retracting passage 18a. When the clip holding member 18
projects from the opening of the passage 10c, each of the engaging
portions 20 is elastically flipped up (that is, opened) around the
distal end radially outward relative to the clip
projecting/retracing passage 18a. The rear ends of the elastically
opened engaging portions 20, located opposite to the distal ends in
the longitudinal direction of the clip projecting/retracting
passage 18a, engage with a periphery of the opening of the passage
10c in the distal end portion 10a of the insertion part 10 in a
direction along the longitudinal center line of the passage 10c,
and prevent the clip holding member 18 from retracting into the
opening of the passage 10c in the distal end portion 10a of the
insertion part 10.
[0014] The clip unit 14 further comprises a connecting member 22
which is provided in the clip projecting/retracting passage 18a of
the clip holding member 18 and which is movable in the extending
direction of the clip projecting/retracing passage 18a. The
connecting member 22 is connected to the proximal end portions 12b
of the slender arms 12c of the clip 12 and to the clip connecting
portion 16b of the clip operating part 16. The connecting member 22
is operated by the clip operating part 16 to move together with the
clip 12 in the above described extending direction in the clip
projecting/retracing passage 18a. The connecting member 22 has a
breakable portion 22a which is broken when a pulling force larger
than a predetermined value is applied thereto by the clip operating
part 16.
[0015] In the conventional example shown in FIGS. 5, 6A and 6B, two
engaging portions 20 are provided at two positions in the clip
holding member 18, the two positions being separated from each
other by 180.degree. in a circumferential direction of the clip
holding member 18 around the clip projecting/retracting passage
18a. The clip holding member 18 and the two engaging portions 20
are formed as one body by injection molding of synthetic resin with
appropriate elasticity and high intensity, such as polyphthalamide
(PPA), polyamide (PA), and the like.
[0016] The connecting member 22 is formed by injection molding of
resin material with high intensity, such as liquid crystal polymer,
nylon, and the like. The breakable portion 22a is a cut out which
is cut from a part of an outer circumferential surface of the
connecting member 22 inwardly in a radial direction of the clip
holding member 18 and which extends in a direction crossing the
extending direction of the clip projecting/retracting passage 18a.
In this cut out, the other ends 12b connected to each other in the
slender arms 12c of the clip 12 are hooked.
[0017] A proximal end portion 22b of the connecting member 22 is
branched into two sections, the proximal end portion 22b being
closer to the distal end portion 10a of the insertion part 10 than
the breakable portion 22a. Two branched sections are close to each
other with a radially extending division line 22c interposed
therebetween, and a connection hole 22d extending along the
longitudinal center line of the clip projecting/retracting passage
18a is formed in closely facing ends of the branched sections. In
the connection hole 22d at the two branched sections of the
proximal end portion 22b of the connecting member 22, a
substantially conically shaped engaging portion 16c of a projecting
end of a projection projecting from the distal end of the clip
connecting portion 16b of the clip operating part 16 in the
longitudinal direction of the clip operating part 16 is pressed in,
so that a rotational connection between the two branched sections
of the proximal end portion 22b of the connecting member 22 and the
clip connecting portion 16b of the clip operating part 16 is
achieved.
[0018] A part of the outer circumferential surface of the
connecting member 22 is flattened, and a part of the inner
circumferential surface of the clip projecting/retracting passage
18a of the clip holding member 18, the part corresponding to the
flattened part of the outer circumferential surface of the
connecting member 22, is also flattened. The flattened part of the
inner circumferential surface of the clip projecting/retracing
passage 18a extends in a moving range of the flattened part of the
outer circumferential surface of the connecting member 22 while the
connecting member 22 moves in the clip projecting/retracting
passage 18a. As a result, the connecting member 22 does not rotate
in the circumferential direction of the clip projecting/retracting
passage 18a in the clip projecting/retracting passage 18a.
[0019] A moving path of the breakable part 22a of the connecting
member 22 in the clip projecting/extracting passage 18a is adjacent
to the inside surface of one of the two engaging portions 20.
[0020] Next, a process of ligaturing a desired region of a desired
living tissue in a body cavity of a living thing, for example a
human body, by using the conventional clip apparatus configured as
described above.
[0021] First, the insertion part of the not-shown endoscope is
inserted into the body cavity, and the distal end of the insertion
tube is directed to the desired region of the desired living
tissue. Then, the insertion part 10 of the conventional clip
apparatus is inserted into the not-shown forceps channel of the
endoscope with the distal end portion 10a being as the leading end.
In this time, the clip 12 is retracted into the clip
projecting/retracting passage 18a of the clip holding member 18,
and the clip holding member 18 is retracted into the distal end
portion of the passage 10c of the insertion part 10.
[0022] After the distal end portion 10a of the insertion part 10 is
projected from the distal end opening of the forceps channel of the
insertion part of the endoscope, the external operation portion 16a
of the clip operating part 16 is pushed to project the clip holding
member 18 from the distal end portion of the passage 10c of the
insertion part 10 and to project the clip 12 from the clip
projecting/retracing passage 18a of the clip holding member 18.
[0023] Each of the two engaging portions 20 of the projected clip
holding member 18 is elastically flipped up (that is, opened)
around its distal end outward in the radial direction of the clip
holding member 18, as shown in FIG. 7A. The rear ends of the opened
engaging portions 20 are engaged with the periphery of the opening
of the passage 10c in the distal end portion 10a of the insertion
part 10 in the direction along the longitudinal center line of the
passage 10c, and prevent the clip holding member 18 from retracting
into the opening of the passage 10c in the distal end portion 10a
of the insertion part 10.
[0024] As shown in FIG. 7A, the projected clip 12 opens the arms
12c around the other ends 12b outward in the radial direction of
the clip projecting/retracing passage 18a. Thereafter, in order to
locate the gap between the opened distal ends 12a of the arms 12c
of the clip 12 on the desired region DR of the desired living
tissue in the body cavity of the living thing, for example the
human body, the direction of the distal end portion of the
insertion part of the not-shown endoscope (that is, the direction
of the distal end portion 10a of the insertion part 10) and the
push amount of the external operation portion 16a of the clip
operating part 16 directing the proximal end portion 10b of the
insertion part 10 (that is, the projecting distance of the clip 12
from the clip projecting/retracting passage 18a of the clip holding
member 18) are adjusted.
[0025] Then, after the external operation portion 16a is pushed to
make the opened distal ends 12a of the arms 12c of the clip 12 bite
the desired region DR of the desired living tissue, the external
operation portion 16a is pulled while holding the proximal end
portion 10b of the insertion part 10 not to move the insertion part
10 in its longitudinal direction. As a result, while the arms 12c
of the clip 12 are pulled into the clip projecting/retracting
passage 18a of the clip holding member 18, the outside surfaces of
the arms 12c slidingly contact the periphery of the opening of the
clip projecting/retracing passage 18a at the projecting end of the
clip holding member 18 and are pushed inward in the radial
direction of the opening, so that the distal ends 12a of the arms
12c of the clip 12 can hold the desired region DR of the desired
living tissue, as shown in FIG. 7B.
[0026] By pulling the external operation portion 16a furthermore, a
pulling resistance generated in the desired region DR of the
desired living tissue and a frictional resistance generated on the
outside surface of the arms 12c of the clip 12 with respect to the
periphery of the opening of the clip projecting/retracing passage
18a are increased, so that the pulling force applied to the base of
the breakable portion 22a of the connecting member 22 by the clip
operating part 16 gets close to a predetermined value at which the
base of the breakable portion 22a is to be broken.
[0027] Just before the base of the breakable portion 22a of the
connecting member 22 is broken, a deviating force BF around the
base is applied to a distal end portion 22e of the connecting
member 22, as shown in FIG. 7C.
[0028] In a case that the opening distance of the distal ends 12a
of the arms 12c of the clip 12 is relative large when the opened
distal ends 12a of the arms 12c of the clip 12 bites the desired
region DR of the desired living tissue as shown in FIG. 7B, the
deviating force BF around the base is applied to the distal end
portion 22e of the connecting member 22 as shown in FIG. 7C before
the arms 12c of the clip 12 are sufficiently pulled into the clip
projecting/retracting passage 18a of the clip holding member
18.
[0029] In this time, the distal end portion 22e of the connecting
member 22 faces the inside surface of one of the two engaging
portions 20 of the clip holding member 18 in the clip
projecting/retracing passage 18a. Therefore, the distal end portion
22e of the connecting member 22 to which the deviating force BF is
applied pushes the inside surface of the engaging portion 20
corresponding to the distal end portion 22e of the connecting
member 22 outward in the radial direction of the clip
projecting/retracting passage 18a, until the base of the breakable
portion 22a of the connecting member 22 is broken as shown in FIG.
7D.
[0030] As a result, the arms 12c of the clip 12 are prevented from
being pulled furthermore into the clip projecting/retracting
passage 18a of the clip holding member 18, so that the bite of the
distal ends 12a of the arms 12 of the clip 12 in the desired region
DR of the desired living tissue (that is, the ligaturing of the
desired region DR of the desired living tissue) is left
insufficiently.
[0031] In addition to the conventional clip apparatus described
above with reference to FIGS. 5 to 7D, another conventional clip
apparatus is known. The other conventional clip apparatus is only
different from the above described conventional clip apparatus in
that a direction RO in which the engaging portion 20 close to the
base of the breakable portion 22a of the connecting member 22 in
the clip holding member 18 bends elastically is displaced in the
circumferential direction of the clip holding member 18 by
45.degree. from a direction in which the deviating force BF around
the base applied to the distal end portion 22e of the connecting
member 22 just before the base of the breakable portion 22a of the
connecting member 22 is broken, as shown in FIGS. 8A and 8B.
[0032] Even in such the other conventional clip apparatus, the same
problems as that occurred in the conventional clip apparatus
described above with reference to FIGS. 5 to 7D are occurred.
BRIEF SUMMARY OF THE INVENTION
[0033] A clip apparatus for ligaturing a living tissue according to
one aspect of this invention comprises: an insertion part which
includes a distal end portion, a proximal end portion and a passage
extending between the distal end portion and the proximal end
portion and which is inserted into a forceps channel of an
endoscope inserted into an body cavity of a living thing with the
distal end portion being as an leading end; a clip unit which is
removably provided in the distal end portion of the insertion part
and which includes a clip having slender arms having independent
distal ends and proximal ends connected to each other, the clip
being capable of elastically opening and closing the distal ends;
and a clip operating part which includes an external operation
portion exposed at the proximal end portion of the insertion part
and a clip connecting portion extending in the passage of the
insertion part from the external operation portion to the distal
end portion and connected to the clip unit and which is configured
to open and close the clip of the clip unit by operating the
external operation portion.
[0034] The clip unit includes: a clip holding member which has a
diameter smaller than that of the opening of the passage in the
distal end portion of the insertion part and a clip
projecting/retracting passage extending along a longitudinal center
line of the passage, holding the clip to be capable of projecting
and retracting the clip, and elastically opening and closing the
arms of the clip by projecting and retracting of the clip; an
engaging portion which is provided around the clip
projecting/retracting passage in the clip holding member and which
is elastically openable and closable in a radial direction of the
clip projecting/retracting passage, the engaging portion being
pushed by an inner circumferential surface of the passage and
elastically closed while the clip holding member is retracted in
the opening of the passage in the distal end portion of the
insertion part, and elastically opened when the clip holding member
projects from the opening of the passage and engaging with a
periphery of the opening of the passage in the distal end portion
of the insertion part in a direction along the longitudinal center
line of the passage; a connecting member which is provided in the
clip projecting/retracting passage of the clip holding member to be
movable in an extending direction of the clip projecting/retracting
passage, which is connected to the proximal ends of the arms and
the clip connecting portion of the clip operating part to move
together with the clip in the clip projecting/retracting passage in
the extending direction by operating the clip operating part, and
which has a breakable portion and a distal end portion closer to
the clip than the breakable portion, the breakable portion being to
be broken when a pulling force higher than a predetermined value is
applied by the clip operating part; and an engaging portion
excessive opening preventing structure which prevents excessive
opening of the engaging portion by a deviating force directed
outward in the radial direction and applied to the distal end
portion of the connecting member as the breakable portion of the
connecting member is broken.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0035] The accompanying drawings, which are incorporated in and
constitute a part of the specification, illustrate embodiments of
the invention, and together with the general description given
above and the detailed description of the embodiments given below,
serve to explain the principles of the invention.
[0036] FIG. 1 is an enlarged longitudinal sectional view of a clip
unit that is an essential part of a clip apparatus for ligaturing a
living tissue according to a first embodiment of the present
invention;
[0037] FIGS. 2A, 2B, 2C and 2D are longitudinal section views
showing sequential steps of an operation for ligaturing a desired
region of a desired living tissue in a body cavity of a living
thing by using the clip unit of the clip apparatus of FIG. 1;
[0038] FIG. 3 is an enlarged longitudinal sectional view of a clip
unit that is an essential part of a clip apparatus for ligaturing a
living tissue according to a second embodiment of the
invention;
[0039] FIG. 4A is an enlarged longitudinal sectional view of a clip
unit that is an essential part of a clip apparatus for ligaturing a
living tissue according to a third embodiment of the invention;
[0040] FIG. 4B is a transverse sectional view taken along a line
IVB-IVB in FIG. 4A;
[0041] FIG. 5 is a perspective view of a whole conventional clip
apparatus for ligaturing a living tissue;
[0042] FIG. 6A is an enlarged longitudinal sectional view of a clip
unit that is an essential part of the conventional clip apparatus
for ligaturing a living tissue shown in FIG. 5;
[0043] FIG. 6B is a transverse sectional view taken along a line
VIB-VIB in FIG. 6A;
[0044] FIGS. 7A, 7B, 7C and 7D are longitudinal section views
showing sequential steps of an operation for ligaturing a desired
region of a desired living tissue in a body cavity of a living
thing by using the clip unit of the clip apparatus shown in FIGS.
6A and 6B;
[0045] FIG. 8A is a half sectional view of a clip unit that is an
essential part of another conventional clip apparatus for
ligaturing a living tissue; and
[0046] FIG. 8B is a transverse sectional view taken along a line
VIIIB-VIIIB in FIG. 5A.
DETAILED DESCRIPTION OF THE INVENTION
First Embodiment
[0047] A configuration of a clip apparatus for ligaturing a living
tissue according to a first embodiment of the invention will be
explained hereinafter with reference to FIG. 1.
[0048] Most of the structural elements of the clip apparatus for
ligaturing a living tissue according to the first embodiment are
the same as those of the conventional clip apparatus for ligaturing
a living tissue already described with reference to FIGS. 5, 6A and
6B. Therefore, the structural elements of the clip apparatus for
ligaturing a living tissue according to the first embodiment, which
are the same as those of the conventional clip apparatus for
ligaturing a living tissue described with reference to FIGS. 5, 6A
and 6B, are denoted by the same reference numerals as those
denoting the same structural elements of the conventional clip
apparatus for ligaturing a living tissue, and detailed description
of these structural elements will be omitted.
[0049] The configuration of the clip apparatus according to the
first embodiment is different from that of the conventional clip
apparatus in that the clip apparatus according to the first
embodiment is provided with an engaging portion excessive opening
preventing structure 24. The excessive opening preventing structure
24 prevents excessive opening of the engaging portion 20 caused by
the deviating force BF (refer to FIG. 7C) applied to the portion
closer to the clip 12 than the breakable portion 22a (namely, the
distal end portion 22e) in the connecting member 22 when the
breakable portion 22a of the connecting member 22 is broken and
directing outward in the radial direction of the clip
projecting/retracing passage 18a.
[0050] Specifically, the engaging portion excessive opening
preventing structure 24 in this embodiment includes an opening
restriction portion 26 which is provided in the engaging portion
20, which has a facing region 26 facing a part adjacent to the
opening of the passage 10c in the distal end portion 10a of the
insertion part 10 while the engaging portion 20 is elastically
opened, and which restricts the opening of the engaging portion 20.
The facing region 26a of the opening restriction portion 26 is
configured by a slope inclined inward in a radial direction of the
passage 10c of the insertion part 10 as separating from the opening
along the extending direction of the passage 10c.
[0051] The opening restriction portion 26 is formed by injection
molding of the same material as that of the engaging portion 20, or
the clip holding member 18, simultaneously with the engaging
portion 20 and clip holding member 18. A maximum distance D1
between the two facing regions 26a of the two engaging portions 20
in the radial direction of the passage 10c of the insertion part 10
is the same as or slightly smaller than the diameter D2 of the
passage 10c of the insertion part 10.
[0052] Next, an operation for ligaturing a desired region of a
desired living tissue in a body cavity of a living thing, for
example a human body, by using the clip apparatus according to the
first embodiment of the invention configured as described
above.
[0053] First, an insertion part of a not-shown endoscope is
inserted into the body cavity, and a distal end of the insertion
part is directed to the desired region of the living tissue. Next,
the insertion part 10 (refer to FIG. 5) of the clip apparatus is
inserted into a not-shown forceps channel of the endoscope with the
distal end portion 10a being as a leading end. In this time, the
clip 12 is retracted into the clip projecting/retracting passage
18a of the clip holding member 18, and the clip holding member 18
is retracted into the distal end portion of the passage 10c of the
insertion part 10.
[0054] After the distal end portion 10a of the insertion part 10 is
projected from the distal end opening of the forceps channel of the
insertion part of the endoscope, the external operation portion 16a
(refer to FIG. 5) of the clip operating part 16 is pushed to
project the clip holding member 18 from the distal end portion of
the passage 10c of the insertion part 10, and the clip 12 is
projected from the clip projecting/retracing passage 18a of the
clip holding member 18.
[0055] Each of the two engaging portions 20 of the projected clip
holding member 18 is elastically flipped up (opened) outward about
its distal end in the radial direction of the clip holding member
18, as shown in FIG. 2A. The rear ends of the opened engaging
portions 20 engage with the periphery of the opening of the passage
10c in the distal end portion 10a of the insertion part 10 in a
direction along the longitudinal center line of the passage 10c,
and prevent the clip holding member 18 from retracting into the
opening of the passage 10c in the distal end portion 10a of the
insertion part 10. At the same time, the inclined facing region 26a
of the opening restriction portion 26 formed as one body with the
engaging portion 20 faces the part adjacent to the opening of the
passage 10c in the distal end portion 10a of the insertion part
10.
[0056] The maximum distance D1 between the two facing regions 26a
of the two engaging portions 20 in the radial direction of the
passage 10c of the insertion part 10 is the same as or slightly
smaller than the diameter D2 of the passage 10c of the insertion
part 10. Further, the facing region 26a of the opening restriction
portion 26 is configured by the slope inclined inward in the radial
direction of the passage 10c as separating from the opening along
the extending direction of the passage 10c of the insertion part
10.
[0057] Therefore, the two opening restriction portions 26 of the
two engaging portions 20 allows the rear ends of the two opened
engaging portions 20 to engage with a periphery of the opening of
the passage 10c in the distal end portion 10a of the insertion part
10 in a direction along the longitudinal center line of the passage
10c, so that the clip holding member 18 is prevented from entering
into the opening of the passage 10c in the distal end portion 10a
of the insertion part 10. This means that correct positioning of
the clip holding member 18 to the distal end of the distal end
portion 10a of the insertion part 10 is not prevented by the two
opening restriction portions 26 of the two engaging portions
20.
[0058] As shown in FIG. 2A, the arms 12c of the projected clip 12
are opened about the other ends 12b outward in the radial direction
of the clip projecting/retracing passage 18a. Thereafter, in order
to locate a gap between the opened distal ends 12a of the arms 12c
of the clip 12 to the desired region DR of the desired living
tissue in the body cavity of the living things, for example the
human body, the direction of the distal end portion of the
insertion part of the not-shown endoscope (that is, the direction
of the distal end portion 10a of the insertion part 10) and the
push amount of the external operation portion 16a of the clip
operating part 16 toward the proximal end portion 10b of the
insertion part 10 (e.g., the projecting distance of the clip 12
from the clip projecting/retracting passage 18a of the clip holding
member 18) are adjusted.
[0059] Then, after the external operation portion 16a is further
pushed to make the opened distal ends 12a of the arms 12c of the
clip 12 bite the desired region DR of the desired living tissue,
the external operation portion 16a is pulled while holding the
proximal end portion 10b of the insertion part 10 not to move the
insertion part 10 in its longitudinal direction. As a result, while
the arms 12c of the clip 12 are pulled into the clip
projecting/retracting passage 18a of the clip holding member 18,
the outside surfaces of the arms 12c slidingly contact the
periphery of the opening of the clip projecting/retracing passage
18a at the projection end of the clip holding member 18, so that
the arms 12c are pushed inward in the radial direction of the
opening and the distal ends 12a of the arms 12c of the clip 12 can
hold the desired region DR of the desired living tissue, as shown
in FIG. 2B.
[0060] By further pulling the external operation portion 16a, a
pulling resistance generated in the desired region DR of the
desired living tissue and a frictional resistance generated on the
outside surfaces of the arms 12c of the clip 12 to the periphery of
the opening of the clip projecting/retracing passage 18a are
increased, so that a pulling force applied from the clip operating
portion 16 to the base of the breakable portion 22a of the
connecting member 22 gets close to a predetermined value to break
the base.
[0061] Just before the base of the breakable portion 22a of the
connecting member 22 is broken, a deviating force BF around the
base is applied to the distal end portion 22e of the connecting
member 22, as shown in FIG. 2C.
[0062] In a case that the opening distance of the distal ends 12a
of the arms 12c of the clip 12 is relative large when the opened
distal ends 12a of the arms 12c of the clip 12 bites the desired
region DR of the desired living tissue as shown in FIG. 2B, the
deviating force BF around the base is applied to the distal end
portion 22e of the connecting member 22 as shown in FIG. 2C, before
the arms 12c of the clip 12 are sufficiently pulled into the clip
projecting/retracting passage 18a of the clip holding member
18.
[0063] In this time, the distal end portion 22e of the connecting
member 22 faces the inside surface of one of the two engaging
portions 20 of the clip holding member 18 in the clip
projecting/retracing passage 18a. Therefore, the distal end portion
22e of the connecting member 22 to which the deviating force BF is
applied pushes the inside surface of the engaging portion 20
corresponding to the distal end portion 22e outward in the radial
direction of the clip projecting/retracting passage 18a, until the
base of the breakable portion 22a of the connecting member 22 is
broken.
[0064] However, since the inclined facing region 26a of the opening
restriction portion 26 formed as one body with the one engaging
portion 20 contacts the part adjacent to the opening of the passage
10c in the distal end portion 10a of the insertion part 10, the one
engaging portion 20 resists the deviating force BE applied from the
distal end portion 22e of the connecting member 22 and does not
open furthermore.
[0065] As a result, retraction of the arms 12c of the clip 12 into
the clip projecting/retracting passage 18a of the clip holding
member 18 is not stopped until the base of the breakable portion
22a of the connecting member 22 is completely broken. When the base
of the breakable portion 22a of the connecting member 22 is
completely broken, the arms 12c of the clip 12 are sufficiently
pulled into the clip projecting/retracting passage 18a of the clip
holding member 18, as shown in FIG. 2D.
[0066] Therefore, after the base of the breakable portion 22a of
the connecting member 22 is completely broken, the arms 12c of the
clip 12 are sufficiently pulled into the clip projecting/retracting
passage 18a of the clip holding member 18 so that the clip 12
biting (ligaturing) strongly the desired region DR of the desired
living tissue by the distal ends 12a of the arms 12c is left in the
body cavity together with the clip holding member 18 and the distal
end portion 22e of the connecting member 22.
Second Embodiment
[0067] Next, a configuration of a clip apparatus for ligaturing a
living tissue according to a second embodiment of the invention
will be explained hereinafter with reference to FIG. 3.
[0068] Most of the structural elements of the clip apparatus for
ligaturing a living tissue according to the second embodiment are
the same as those of the conventional clip apparatus for ligaturing
a living tissue already described with reference to FIGS. 5, 6A and
6B. Therefore, the structural elements of the clip apparatus for
ligaturing a living tissue according to the second embodiment,
which are the same as those of the conventional clip apparatus for
ligaturing a living tissue described with reference to FIGS. 5, 6A
and 6B, are denoted by the same reference numerals as those
denoting the same structural elements of the conventional clip
apparatus for ligaturing a living tissue, and detailed description
of these structural elements will be omitted.
[0069] The configuration of the clip apparatus according to the
second embodiment is different from that of the conventional clip
apparatus in that the clip apparatus according to the second
embodiment is provided with an engaging portion excessive opening
preventing structure 24. The excessive opening preventing structure
24 prevents excessive opening of the engaging portion 20 caused by
the deviating force BF (refer to FIG. 7C) applied to the portion
closer to the clip 12 than the breakable portion 22a (namely, the
distal end portion 22e) in the connecting member 22 when the
breakable portion 22a of the connecting member 22 is broken and
directing outward in the radial direction of the clip
projecting/retracing passage 18a.
[0070] Specifically, the engaging part excessive opening prevention
structure 24 in this embodiment includes a setting of a distance L1
from a clip projecting/retracting opening of the clip
projecting/retracting passage 18a of the clip holding member 18 to
a distal end of the engaging portion 20 (the distal end of the
engaging portion 20 is located in a side of the clip
projecting/retracting opening of the clip projecting/retracting
passage 18a) longer than a distance L2 from the distal ends 12a of
the arms 12c of the clip 12 to the distal end of the distal end
portion 22e located closer to the distal ends 12a of the clip 12
than the breakable portion 22a in the connecting member 22.
[0071] The clip 12 pushed by the clip operating member 16 (refer to
FIG. 5) to hold the desired region RD of the desired living tissue
projects the arms 12c from the distal end opening of the clip
projecting/retracing passage 18a of the clip holding member 18, and
the distal ends 12a of the arms 12c are pressed on an area around
the desired region DR of the desired living tissue, as shown in
FIG. 2A.
[0072] Thereafter, the clip 12 is pulled by the clip operating
member 16 (refer to FIG. 5) and the arms 12c of the clip 12 are
pulled into the clip projecting/retracting passage 18a of the clip
holding member 18. In this time, the outside surfaces of the arms
12c of the clip 12 slidingly contact the periphery of the opening
of the clip projecting/retracting passage 18a at the projected end
of the clip holding member 18, so that the arms 12c are pushed
inward in the radial direction of the above opening and the distal
ends 12a of the arms 12c of the clip 12 can hold the desired region
DR of the desired living tissue, as shown in FIG. 2B.
[0073] While the external operation portion 16a is pulled
furthermore, a pulling resistance generated in the desired region
DR of the desired living tissue and a frictional resistance
generated on the outside surfaces of the arms 12c of the clip 12 to
the periphery of the opening of the clip projecting/retracing
passage 18a are increased, so that the pulling force applied to the
base of the breakable portion 22a of the connecting member 22 by
the clip operating portion 16 gets close to the predetermined value
to break the base.
[0074] Just before the base of the breakable portion 22a of the
connecting member 22 is broken, a deviating force BF around the
base is applied to the distal end portion 22e of the connecting
member 22, as shown in FIG. 2C.
[0075] However, in this time, the distal end of the distal end
portion 22e of the connecting member 22 does not reach a position
corresponding to the distal end of one of two engaging portions 20
of the clip holding member 18 in the clip projecting/retracting
passage 18a.
[0076] The base of the breakable portion 22a of the connecting
member 22 is completely broken before the distal ends 12a of the
arms 12c of the clip 12 holding the desired region DR of the
desired living tissue reaches the opening of the clip
projecting/retracting passage 18a at the projected end of the clip
holding member 18 (that is, before the distal end of the distal end
portion 22e located closer to the distal ends 12a of the clip 12
than the breakable portion 22a in the connecting member 22 reaches
the distal ends of the two engaging portions 20 of the clip holding
member 18).
[0077] As described before, by the engaging part excessive opening
preventing structure 24 in this embodiment, the distance L1 from
the clip projecting/retracting opening in the clip
projecting/retracting passage 18a of the clip holding member 18 to
the end of the engaging portion 20 located in the side of the clip
projecting/retracting opening (that is, the distal end of the
engaging portion 20) is set longer than the distance L2 from the
distal ends 12a of the arms 12c of the clip 12 to the distal end of
the distal end portion 22e located closer to the distal ends of the
clip 12 than the breakable portion 22a in the connecting member
22.
[0078] Therefore, until the base of the breakable portion 22a of
the connecting member 22 is broken, the distal end of the distal
end portion 22e of the connecting member 22 to which the deviating
force BF is applied slidingly contacts an area on the inner
circumferential surface of the clip projecting/retracting passage
18a located closer to the projected end of the clip holding member
18 than the distal ends of the two engaging portions 20. This means
that, until the base of the breakable portion 22a of the connecting
member 22 is broken, the distal end of the distal end portion 22e
of the connecting member 22 to which the deviating force BF is
applied does not push the inside surface of the corresponding
engaging portion 20 outward in the radial direction of the clip
projecting/retracting passage 18a.
[0079] As a result, the retraction of the arms 12c of the clip 12
into the clip projecting/retraction passage 18a of the clip holding
member 18 is not stopped until the base of the breakable portion
22a of the connecting member 22 is completely broken. When the base
of the breakable portion 22a of the connecting member 22 is
completely broken, the arms 12c of the clip 12 are sufficiently
pulled into the clip projecting/retracting passage 18a of the clip
holding member 18, as shown in FIG. 2D.
[0080] Therefore, after the base of the breakable portion 22a of
the connecting member 22 is completely broken, the arms 12c of the
clip 12 are sufficiently pulled into the clip projecting/retracting
passage 18a of the clip holding member 18, so that the clip 12
biting (ligaturing) strongly the desired region DR of the desired
living tissue by the distal ends 12a of the arms 12c is left in the
body cavity together with the clip holding member 18 and the distal
end portion 22e of the connecting member 22, as shown in FIG.
2D.
Third Embodiment
[0081] Next, a configuration of a clip apparatus for ligaturing a
living tissue according to a third embodiment of the invention will
be explained hereinafter with reference to FIGS. 4A and 4B.
[0082] Most of the structural elements of the clip apparatus for
ligaturing a living tissue according to the third embodiment are
the same as those of the conventional clip apparatus for ligaturing
a living tissue already described with reference to FIGS. 5, 6A and
6B. Therefore, the structural elements of the clip apparatus for
ligaturing a living tissue according to the third embodiment, which
are the same as those of the conventional clip apparatus for
ligaturing a living tissue described with reference to FIGS. 5, 6A
and 6B, are denoted by the same reference numerals as those
denoting the same structural elements of the conventional clip
apparatus for ligaturing a living tissue, and detailed description
of these structural elements will be omitted.
[0083] The configuration of the clip apparatus according to the
third embodiment is different from that of the conventional clip
apparatus in that the clip apparatus according to the third
embodiment is provided with an engaging portion excessive opening
preventing structure 24. The excessive opening preventing structure
24 prevents excessive opening of the engaging portion 20 caused by
the deviating force BE (refer to FIG. 7C) applied to the portion
closer to the clip 12 than the breakable portion 22a (namely, the
distal end portion 22e) in the connecting member 22 when the
breakable portion 22a of the connecting member 22 is broken and
directing outward in the radial direction of the clip
projecting/retracing passage 18a.
[0084] Specifically, the engaging part excessive opening preventing
structure 24 in this embodiment, as shown in FIG. 4B, includes
separating and making independent an opening/closing direction RO
of the engaging portion 20 and a direction in which the deviating
force BF directs from and of the each other in a circumferential
position around the extending direction of the clip
projecting/retracting passage 18a. In this embodiment, the
opening/closing direction RO of the engaging portion 20 and the
direction in which the deviating force BF directs are separated
from each other by 90.degree. in the circumferential position
around the extending direction of the clip projecting/retracting
passage 18a and independent of each other.
[0085] The clip 12 pushed by the clip operating member 16 (refer to
FIG. 5) to hold the desired region RD of the desired living tissue
projects the arms 12c of the clip 12 from the distal end opening of
the clip projecting/retracing passage 18a of the clip holding
member 18, and the distal ends 12a of the arms 12c are pressed on
an area around the desired region DR of the desired living tissue,
as shown in FIG. 2A.
[0086] Thereafter, the arms 12c of the clip 12 are pulled into the
clip projecting/retracting passage 18a of the clip holding member
18 by the clip operating member 16 (refer to FIG. 5), and the
outside surfaces of the arms 12c of the clip 12 slidingly contact
the periphery of the opening of the clip projecting/retracting
passage 18a at the projected end of the clip holding member 18 so
that the arms 12c are pushed inward in the radial direction of the
above opening and the distal ends 12a of the arms 12c of the clip
12 can hold the desired region DR of the desired living tissue, as
shown in FIG. 2B.
[0087] When the external operation portion 16a is pulled
furthermore, a pulling resistance generated in the desired region
DR of the desired living tissue and a frictional resistance
generated on the outside surfaces of the arms 12c of the clip 12 to
the periphery of the opening of the clip projecting/retracing
passage 18a are increased so that the pulling force applied to the
base of the breakable portion 22a of the connecting member 22 by
the clip operating part 16 gets close to the predetermined value to
break the base.
[0088] Just before the base of the breakable portion 22a of the
connecting member 22 is broken, the deviating force BF around the
base is applied to the distal end portion 22e of the connecting
member 22, as shown in FIG. 4A.
[0089] However, in this embodiment, the opening/closing direction
RO of the engaging portion 20 and the direction in which the
deviating force BF directs are separated from each other in the
circumferential position around the extending direction of the clip
projecting/retracting passage 18a and independent of each other.
Therefore, in this time, the distal end portion 22e of the
connecting member 22 does not face the inside surface of any of the
two engaging portions 20 of the clip holding member 18 in the clip
projecting/retracting passage 18a.
[0090] This means that, until the base of the breakable portion 22a
in the connecting member 22 is broken, the distal end of the distal
end portion 22e of the connecting member 22 to which the deviating
force BF is applied does not push the inside surface of any of the
two engaging portions 20 outward in the radial direction of the
clip projecting/retracting passage 18a.
[0091] As a result, the retraction of the arms 12c of the clip 12
into the clip projecting/retracting passage 18a of the clip holding
member 18 is not stopped until the base of the breakable portion
22a in the connecting member 22 is completely broken. When the base
of the breakable portion 22a in the connecting member 22 is
completely broken, the arms 12c of the clip 12 are sufficiently
pulled into the clip projecting/retracting passage 18a of the clip
holding member 18, as shown in FIG. 2D.
[0092] Therefore, after the base of the breakable portion 22a in
the connecting member 22 is completely broken, the arms 12c of the
clip 12 are sufficiently pulled into the clip projecting/retracting
passage 18a of the clip holding member 18 so that the clip 12
biting (ligaturing) strongly the desired region DR of the desired
living tissue by the distal ends 12a of the arms 12c is left in the
body cavity together with the clip holding member 18 and the distal
end portion 22e of the connecting member 22, as shown in FIG.
2D.
[0093] In this embodiment, the opening/closing direction RO of the
engaging portion 20 and the direction in which the deviating force
BF directs are separated from each other by 90.degree. in the
circumferential position around the extending direction of the clip
projecting/retracting passage 18a and independent of each other, in
order to separate the opening/closing direction RO of the engaging
portion 20 and the direction in which the deviating force BF
directs from each other an to make them independent of each other
in the circumferential position around the extending direction of
the clip projecting/retracting passage 18a. However, in order to
separate the opening/closing direction RO of the engaging portion
20 and the direction in which the deviating force BF directs from
each other and making them independent of each other in the
circumferential position around the extending direction of the clip
projecting/retracting passage 18a, the opening/closing direction RO
of the engaging portion 20 and the direction in which the deviating
force BF directs may be separated over 45.degree. in the
circumferential position around the extending direction of the clip
projecting/retracting passage 18a.
[0094] Additional advantages and modifications will readily occur
to those skilled in the art. Therefore, the invention in its
broader aspects is not limited to the specific details and
representative embodiments shown and described herein. Accordingly,
various modifications may be made without departing from the spirit
or scope of the general inventive concept as defined by the
appended claims and their equivalents.
* * * * *